Biomedical subjects
Publications and source records attributed to A Puigvert.
Thirty-three cases of malignant renal tumour removed by partial nephrectomy are discussed. The indications of this conservative therapy as well as the surgical technique, the results obtained, especially survivals beyond 10 years, as well as the period of time after which the neoplastic disease can be considered as cured are presented.
For further cytomicrobiological analysis correct urine collection is required because, in women, there is the possibility of contaminating the urine sample at micturition by the saprophyte flora of the vagina. In men, preputial hypertrophy and the germs growing on the prepuce, especially in the smegma, can cause false analytical results which may lead to misdiagnoses and inadequate treatment. To avoid this in women, the urine sample must be taken by urethral catheterization and in men by micturition but exposing the glans to avoid urine contamination by the balanopreputial flora.
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The anatomo-operative characteristics of the ischemic stenosis of the juxtapyelic part of the ureter, its embryogenic fundamentals, clinical semiology and urography, emphasizing the signs of the latter for the differential diagnosis of hydronephrosis are presented. The most adequate surgical technique, that is the extirpation of the scleroatrophic part of the ureter, followed by uretero-pyelostomy, with special care in preserving the arteries of the ureter, is summarized and the technique for the postoperative drainage of the kidney is pointed out. The poor effectiveness of other procedures are commented.
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A case of metastasis of a prostatic carcinoma in the epididymis is reported. The literature is reviewed and discussed.
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Partial nephrectomy has been performed in 21 cases of kidney tumours. It can be used for well-limited parenchymatous tumours and obligatory in patients with a solitary kidney, but is not advisable for tumours originating in the urothelium. These results are compared with the parallel experience with radical surgery and followed during 46 years in the same centre, they give a greater value to this study and encourage the reasoned practice of partial nephrectomy for tumours especially in the solitary kidney.
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In this study the author emphasizes the existence of a muscular element that had not been described until now. This muscular element is situated around Malpighi's pyramid and its fibres are followed by the caliceal muscle and the elements that form Henle's peripapillar ring. The systolic and diastolic function of this peripyramidal muscle can be observed in the urographies, during the evacuation of the collector tubules of Bellini, and its synchronization with the next caliceal and pyelic musculature.
The advantages and drawbacks of the different techniques of the prostate needle biopsy are commented. The reasons for always using the percutaneous perineal approach with Vim-Silvermann's needle, modified by Franklin, in our Centre are pointed out. The results obtained in more than 1,500 biopsies performed in the Institute are briefly presented. A clinical report--the second in our records--in which the perineal implantation of a metastatic nodule occurred in the transcutaneous needle biopsy, is also presented. This complication is in fact a very rare one, and we must not forget all the advantages of this diagnostic pattern. After a thorough revision of the world casuistic, we have only been able to find 8 published cases.